Upper and Lower Crossed Syndrome 101

Since the early 2000’s when smartphones prevailed as the next big thing, we have found postural changes to be more prominent than ever. In fact, postural abnormalities (e.g. Anterior Head Carriage, aka AHC) are the most common findings in patients today. Even though smartphones are one of the main reasons that changes in posture are present, we have to also take into consideration activities such as working a desk job, sitting for prolonged hours, being in front of a computer/watching TV, driving, and reading. These will all influence abnormal changes in posture if not addressed correctly and in time.  It goes without saying that smartphones/computers are here to stay. Having this in mind, being able to adapt to this lifestyle with the right tools will be the best approach to counter the effects of malpositions. In this blog, we’re gonna cover two specific, yet very common findings regarding posture: Upper Crossed and Lower Crossed Syndrome (UCS/LCS). In addition, we’ll include steps to compensate for these syndromes while avoiding the development of new imbalances, as well as exercising/stretching for the muscles involved.


UCS arises from crossed, tight/weak muscle groups that alter posture and the overall integrity of our musculoskeletal system. This imposing unevenness is mostly found in individuals who work at desk jobs or in those who predominately sit throughout the day, leaning forward on their phones, laptops, etc. Adults, as well as kids and teenagers, are primarily affected due to the codependency of technology prevalent in society today. People between 17-21 years of age are where we find the most amount of cases of UCS. For Upper Crossed Syndrome, we find tight (facilitated) mid-trapezius, levator scapulae and pectoralis minor muscle muscles, as well as weak (inhibited) deep neck flexors, rhomboids, lower trapezius and serratus anterior muscles. Therefore lies the reason as to why it is called Upper “Crossed” Syndrome. The visible postural changes that lead to this type imbalance are: anterior head carriage (AHC) where the head is shifted anteriorly on the body’s sagittal plane, rounded shoulders, hyper kyphosis of the thoracic spine, loss of cervical curvature, limited active and passive range of motion (AROM/AROM), and winged scapulas. Some symptoms that people with UCS may experience are:

  • neck pain
  • headache
  • weakness in the front of the neck
  • strain in the back of the neck
  • pain in the upper back and shoulders
  • tightness and pain in the chest
  • jaw pain
  • fatigue
  • lower back pain
  • trouble with sitting to read or watch TV
  • trouble driving for long periods
  • restricted movement in the neck and shoulders
  • pain and reduced movement in the ribs
  • pain, numbness, and tingling in the upper arms

Time has shown that chiropractic care and physical therapy are two of the best solutions to address the postural imbalance as a result of UCS. The tight muscles and poor posture that produce UCS can also cause your joints to become misaligned. A chiropractic adjustment from a licensed practitioner can help to realign these joints. Thus, increasing range of motion in the affected areas. An adjustment stretches and relaxes the shortened muscles in addition to joint realignment. This approach, mixed with soft tissue modalities such as trigger points, manual therapy, vibrating stimulation, and e-stim therapy will certainly aid in reversing UCS, and even LCS.

The concept of Lower Crossed Syndrome follows along the same line as UCS, but it is referred to as “lower” because this imbalance is applied to our hip posture, specifically related to tight/weak muscle groups around our hip. LCS is a dysfunctional musculoskeletal condition, just as in the case of UCS. With LCS we find tight (facilitated) erector spinae and iliopsoas (hip flexor) muscle groups, and weak (inhibited) gluteus maximus and abdominal muscle groups. To successfully target any improvement it is vital to stretch the tight muscles and fortify the weakened muscle groups. This same approach applies to UCS and its respective imbalances. Even though LCS is found less frequently compared to UCS, it is still important to know it exists in order to avoid any possible lower extremity injuries as a result of it. Some of the visual findings we find are: anterior tilted pelvis, hyperlordosis of the lumbar spine, and slight knee/hip flexion. Some of the symptoms caused by LCS are:

  • Reduced mobility or stiffness in lumbar, hip, hamstring, or pelvic region
  • Pain in hip flexors, groin, spine, or buttock muscles
  • Protruding stomach from an overly arched low back
  • Tension in the lower back and/or buttock muscles


We are aware that poor posture is the primary reason why we experience annoying achy symptoms on a daily basis however, this so-called “syndrome” has many solutions! The body LOVES to compensate, and what better way to re-educate our systems to do so but the right way. Below are some videos displaying basic exercises to do at home to aid in teaching your body better habits, better posture, and a better sense of optimal functionality.


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